Vesicovaginal fistula: a major healthcare problem

The aim of this study is to summarize the recent data on vesicovaginal fistula in the developing world. Despite the fact that the literature on this subject does not reach high levels of evidence, the awareness about this devastating condition within the urological field should be increased.

Recently, the International consultation in incontinence revised the recent literature on vesicovaginal fistula. On the basis of recent reports, certain principles of fistula repair, such as the use of Martius flaps, may no longer be valid. On the contrary, the management of fistula repair complications such as persisting incontinence after successful fistula closure are being studied in more detail. These reports progressively change our understanding and treatment of this condition. Concerning the prevention of fistula and the organization of fistula care, new ideas are emerging.

The fistula problem in the developing world is a challenge for the local doctors and the urological and gynaecological communities in our rich countries. The scientific societies should join forces to help improve the fate of fistula patients in African and Asian countries that are confronted with a large number of these women.